The Obamacare war that wasn't

The proxy war over Obamacare that was expected to dominate the Senate in May is looking more and more like a dud.

The chamber will begin consideration next week of Sylvia Mathews Burwell’s nomination to lead the Department of Health and Human Services, the agency tasked with implementing the health care law.

Story Continued Below

Initially, Republicans seemed poised to use the confirmation process to spur further attacks on Obamacare. But instead, more than a half-dozen GOP senators said in interviews that they are impressed with Burwell’s credentials.

In the end, the only thing standing between Burwell and a new seat in President Barack Obama’s Cabinet might be two tough grillings in front of the cameras.

“Cursorily, she looks very good, but she’s going to have to answer some really tough questions, is all I can say,” said Sen. Orrin Hatch of Utah, the top Republican on the Senate Finance Committee, which must vote on Burwell’s nomination before it can go to the Senate floor.

Though Republicans are making Obamacare a centerpiece of their bid to regain control of the Senate, some lawmakers say there’s a difference between their opposing the law and fighting Burwell personally.

“She’s not the one to go after [over] the policy or ideological differences,” said Sen. Richard Burr (R-N.C.), another Finance Committee member. “She’s got to go in and try to run the place. I’m much more concerned that she’s up to snuff on [public health preparedness and the National Institutes of Health] — things where the secretary can have a real impact.”

Democrats — even some of those running for reelection this fall in red states where Obamacare isn’t popular — are widely applauding Obama’s pick. Sen. Mark Begich (D-Alaska) said he had “no real qualms” over her nomination.

That support, in addition to that of some Republicans, means Burwell’s confirmation is hers to lose.

She’ll have to get through two tough confirmation hearings — one in Finance, the other in the Senate Health, Education, Labor and Pensions Committee. And many Republicans indicated that they have big questions for Burwell, who they hope is exponentially more responsive than outgoing HHS Secretary Kathleen Sebelius to their inquiries.

Republicans want assurances that Burwell will reply to their written letters on Obamacare implementation and work with them on other HHS issues — something they say Sebelius rarely did.

But given Republicans’ existing relationship with Burwell at OMB and her unanimous 96-0 Senate approval last year to lead the Office of Management and Budget, Republicans might have little more than tough talk in store for the new steward of Obamacare.

“The interaction I’ve had with her has been very positive,” said Sen. Bob Corker (R-Tenn.). “I know she’s knowledgeable, and I don’t enter thinking about her in that position with any negative thoughts.”

Still, Burwell is not going to get another unanimous confirmation vote.

Some Republicans will still oppose her nomination on Obamacare grounds or because of concerns that she doesn’t have enough of a health care background. Rep. Steve Scalise and four other Louisiana Republican House members are already calling on their state’s senators to put a “hold” on Burwell’s nomination over Obamacare that could delay the vote for a day or two.

But unless she commits a game-changing gaffe during her hearings, it’s possible she will clear the Senate by much more than the 51 votes needed.

“Somebody’s got to do the job,” said Sen. Lindsey Graham (R-S.C.), who’s inclined to support Burwell. “Her challenge is to convince the Congress that they’re going to get real information in a timely fashion about Obamacare, about enrollment, who’s enrolled, what percentage or a certain age group, how many people are paying their premiums. The past lack of transparency is unacceptable.”

Sen. John McCain (R-Ariz.) also said he’s likely to support Burwell. Democrats believe his support and kind words from Republicans like Burr, Graham and Corker will go a long way toward defusing a long-threatened partisan battle over Obamacare.

“It’s going to be impossible for Republicans to misremember their votes on her OMB confirmation just a handful of months ago,” said Sen. Chris Murphy (D-Conn.). “I don’t expect that this is going to be as big a fight as people originally predicted.”

Still, Burwell’s GOP grilling is unlikely to be pleasant, even if her confirmation vote is not in doubt. Sen. John Barrasso of Wyoming, the No. 4 in GOP leadership, said that Burwell will be “held accountable” for the health care regulations she’s developed at OMB.

“I don’t expect her to have a significant willingness to look for ways to head in more effective directions for health care [than the administration has previously supported], and I think that will be a problem in the confirmation process,” said Sen. Roy Blunt of Missouri, a member of GOP leadership. “But, it takes 51 votes, and Democrats have 55.”

Sen. Jeff Sessions of Alabama, who as the top Republican on the Budget Committee interacted with Burwell more than most other lawmakers, called her smart and courteous — but questioned her qualifications for the HHS job and suggested that at this point in Obamacare’s history, the department needs an experienced health care leader from state government or the insurance industry.

“The biggest issue facing America now is what to do about health care, and she lacks experience in that,” he said. “They want a message person who is loyal utterly to the White House, and less emphasis is being placed in running these agencies.”

Several Democrats facing voters this fall indicated that they’ll support her nomination, too, including Begich and Sen. Jeanne Shaheen of New Hampshire.

“She’ll hear from me a lot [on] Indian Health Services and the needs that we have and making sure some of the stuff we’ve worked on gets resolved, but I have no real qualms over her,” Begich said.

He said he hopes Burwell’s confirmation isn’t about Republicans’ disgust with the health law, “because she had nothing to do with it.”